Mario Tama / Getty Images

The GOP’s strategy failed to derail health-care reform, now all but certain to pass. Reihan Salam on how Republicans can turn their opposition to political advantage—and clean up in 2010. Plus, our Big Fat Story presents six takes on the CBO's health-care math.

Though Congress hasn't passed health-care reform legislation just yet, Senate Democrats have cleared what many believe to be the highest hurdle by getting all 60 members of the caucus to unite behind the Reid bill. So while congressional Republicans will continue to maneuver, we can safely say that President Obama has all but achieved his most vitally important legislative goal. If the final legislation looks anything like the Reid bill, it will most likely prove a very grave and very expensive mistake, one that depends on a number of rosy scenarios coming to pass. But for most Democrats, the flaws in the legislation are immaterial. The key goal was to establish the principle that the federal government is responsible for covering all Americans, and that's happened.

Democrats will keep on attacking Republicans as the “Party of No.” But as voters grow increasingly skeptical of Obama’s scattershot efforts to remake the American economy, that’s not necessarily a bad thing.

In a sense, the Democrats have finally avenged the death of Bill Clinton's bid for universal coverage, which set in motion the 1994 Republican congressional takeover and all that followed. Even Evan Bayh, the moderate Democratic senator from Indiana who is far from a party loyalist, reportedly couldn't stand the thought of Republicans gloating over the defeat of health-care reform the second time around. All of the wonky debates you've heard about the virtues and the limits of the various proposals were ultimately a sideshow. There were better and cheaper ways to get to universal coverage, but they all involved alienating a powerful Democratic constituency. Think of the last few months as "Health Care II: Liberalism Strikes Back" and you'll have a better understanding of what was really going on. This must be a sweet, sweet victory for Democrats with long memories.

• Big Fat Story: Health Care’s Scorekeeper• A roundup of health-care opinionsBut there's one small problem. While Ben Nelson is on board, thanks in part to a sweetheart deal for the good people of Nebraska, a majority of voters aren't. The latest Rasmussen survey finds 55 percent opposed and 41 percent in favor. And of course the opposition isn't spread evenly across the map. The president's numbers have been particularly weak among non-college-educated whites, among whom only a third believe that health-care reform will make a positive difference in their lives, according to a poll sponsored by the Kaiser Family Foundation.

These voters are heavily represented in the swing districts that Republicans need to take back the House. One can imagine the Republicans running a scorched-earth campaign calling for a complete rollback of health-care reform, but that's unlikely. The Obama White House is going to pivot to push its spending-driven jobs agenda to blunt the most effective line of attack from the right, namely that private-sector job growth remains extremely weak.

Democrats will keep on attacking Republicans as the "Party of No." But as voters grow increasingly skeptical of Obama's scattershot efforts to remake the American economy, that's not necessarily a bad thing.

Republicans running in 2010 will have to build an agenda centered on spurring job growth. Among other things, candidates could call for using stimulus funds to fund payroll-tax relief and an expanded investment tax credit. This agenda should also include proposals for trimming entitlement spending, but it probably won't.

During the debate over health-care reform, congressional Republicans emerged as the most dogged defenders of the Medicare status quo. In part, this reflects the fact that those non-college-educated voters who aren't thrilled with President Obama are the same swing voters who weren't thrilled with President Bush's calls for reforming Social Security. A large and growing number of Republican voters consider the middle-class welfare state LBJ built to be as American as apple pie.

This poses a serious problem for tax-cutting conservatives over the long run. But it's not going to get resolved in 2010. What Republicans can offer is a check on overreaching Democrats, and that might be more than enough.

Reihan Salam is a fellow at the New America Foundation and the co-author of Grand New Party.